Department of Gynecology and Obstetrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China.
PLoS One. 2021 May 4;16(5):e0251022. doi: 10.1371/journal.pone.0251022. eCollection 2021.
Surgical site infections (SSIs) are common postoperative complications. Whether the use of staples or sutures makes a difference in abdominal surgery's infection rate remains elusive.
A systematic review was performed to identify randomized clinical trials comparing staples and sutures after abdominal surgeries. Eligibility criteria involved the SSI occurrence as the primary outcome and the incidence of wound dehiscence, closure time, cosmesis, and patient satisfaction as the secondary outcomes.
Of the 278 studies identified, seven randomized controlled trials representing 3705 patients were included in this review. There was no significant difference in SSI rates between sutures and staples in general (OR = 0.98, 95% CI = 0.79-1.22, I2 = 44%, P = 0.1) or in a subgroup of gastrointestinal surgery, where subcuticular suturing was found with a comparable SSI risk with skin stapling (OR = 0.85, 95% CI = 0.66-1.09). Staple closure was associated with a shorter surgery duration, whereas sutures appeared to provide better cosmesis and patient satisfaction. Sutures and staples achieved a comparable incidence of dehiscence. There was no significant between-study publication bias.
Our study demonstrated similar outcomes in SSI rate between subcuticular sutures and staples for skin closure in patients undergoing abdominal surgery.
手术部位感染（SSI）是常见的术后并发症。在腹部手术中，使用订书钉还是缝线会影响感染率，但目前仍不清楚。
系统检索比较腹部手术后使用订书钉和缝线的随机临床试验。纳入标准为以 SSI 发生率为主要结局，以伤口裂开、愈合时间、美容效果和患者满意度为次要结局。
在确定的 278 项研究中，有 7 项随机对照试验（代表 3705 名患者）纳入本综述。一般情况下，订书钉和缝线的 SSI 发生率无显著差异（OR = 0.98，95%CI = 0.79-1.22，I2 = 44%，P = 0.1），或在亚组胃肠道手术中，皮下缝合与皮肤订书钉的 SSI 风险相当（OR = 0.85，95%CI = 0.66-1.09）。订书钉闭合术的手术时间更短，而缝线的美容效果和患者满意度似乎更好。缝线和订书钉的裂开发生率相当。未发现研究间发表偏倚有统计学意义。
本研究表明，在腹部手术中，皮下缝合和皮肤订书钉闭合的 SSI 发生率相似。
